Optimizing and understanding semantic feature analysis treatment for aphasia: A randomized controlled comparative-effectiveness trial

优化和理解失语症的语义特征分析治疗：一项随机对照比较有效性试验

• 批准号: 10688141
• 负责人: Michael Walsh Dickey
• 金额: $ 46.01万
• 依托单位: VETERANS HEALTH FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10688141
• 关键词: Address; Affect; Aftercare; Alzheimer' s Disease; American; Aphasia; Area; Behavioral; Bilateral; Brain; Brain imaging; Brain region; Categories; Clinical; Cognitive; Communication; Communication impairment; Data; Equation; Equilibrium; Functional Magnetic Resonance Imaging; Funding; Generations; Growth; Homologous Gene; Hour; Impairment; Language; Language Tests; Left; Lesion; Maintenance; Malignant Neoplasms; Measures; Methods; Modeling; Names; Neurocognitive; Outcome; Participant; Patients; Performance; Persons; Process; Psycholinguistics; Randomized; Reporting; Resolution; Response Generalization; Rest; Retrieval; Semantics; Site; Speech; Standardization; System; Test Result; Testing; Time; Training; Variant; Visual; Word Processing; clinically relevant; comparative effectiveness study; comparative effectiveness trial; efficacious treatment; follow-up; health related quality of life; improved; improved outcome; language processing; lexical; lexical retrieval; neural correlate; neuromechanism; novel; phonology; post intervention; predicting response; recruit; remediation; response; sample fixation; secondary outcome; semantic processing; success; treatment response; treatment trial; visual tracking

This randomized comparative effectiveness trial examines whether active manipulation of a key component of semantic feature analysis (SFA) treatment for word-finding difficulty in aphasia improves outcomes. The key component in question is the number of semantic features that persons with aphasia are asked to generate on each treatment trial. Study participants (n=40) will be recruited and randomized to receive either a many- features version of SFA or a few-features version. In the many-features condition, participants will be asked to generate 11 semantic features for each word practiced. Participants assigned to the few-features condition will be asked to generate 5 features for each word practiced. The total treatment time will be equated in the two conditions. Because each trial will take less time in the few-features condition, participants in this group will cycle through the lists of treated items more often, providing them with more opportunities to practice the phonological form of the targets, at the expense of more elaborated feature generation practice. Correspondingly, the many-features group will receive more practice generating semantic features, at the expense of few opportunities to practice the target word forms. Study participants will be housed locally at the Pittsburgh site for five weeks during which they will receive 60 hours of SFA treatment with pre- and post-treatment assessment of their ability to name pictures of treated and untreated, semantically related nouns. Other secondary outcomes, including measures of connected speech and patient-reported communication ability will also be collected. In order to address unresolved questions about the underlying cognitive and neural mechanisms of SFA, participants will also receive concurrent pre- and post-treatment assessment of automatic word processing ability using eye-tracking methods and functional magnetic resonance imaging (fMRI). Participants will also be asked to return to Pittsburgh for one-month follow-up language, eye-tracking, and fMRI testing. The language testing results will be used to determine the appropriate balance of feature generation practice vs. word form practice to optimize SFA outcomes. The eye-tracking results will be used to infer whether SFA’s positive effects can be attributed to improved activation of lexical-semantic representations, improved ability to inhibit competing representations, or both. The fMRI results will be used to identify the brain networks and activation changes associated with changes in naming ability resulting from SFA. This study will provide theoretically and clinically relevant information about how aphasia treatment should be delivered and the neurocognitive mechanisms underlying its effects.

这项随机比较有效性试验检查是否主动操纵关键组成部分 语义特征分析（SFA）治疗词识别难度的治疗方法可改善结果。钥匙 有问题的组成部分是要求患有失语症的人的语义特征数量 每个治疗试验。研究参与者（n = 40）将被招募并随机分配，以接收很多 功能版本的SFA或一些功能版本。在许多功能的条件下，将要求参与者 为每个单词生成11个语义特征。分配给几个功能条件的参与者将 被要求为每个单词生成5个功能。总治疗时间将等效于两个 状况。因为每个试验在几个功能条件下都会花费更少的时间，所以该组的参与者将 循环浏览经过处理的项目清单，为他们提供更多的机会来练习 目标的语音形式，牺牲了更详细的特征生成实践。 相应地，许多功能组将获得更多的实践，以生成语义功能 练习目标单词形式的机会很少。 研究参与者将在匹兹堡现场安置五个星期，在此期间 在治疗前和治疗后评估其命名治疗图片的能力的60小时SFA治疗 和未经治疗的语义相关名词。其他次要结果，包括连接的度量 还将收集语音和患者报告的沟通能力。为了解决未解决的问题 有关SFA的基本认知和神经机制的问题，参与者也将收到 同时使用眼神跟踪的自动文字处理能力的治疗前和治疗后评估 方法和功能磁共振成像（fMRI）。还将要求参与者返回 匹兹堡使用一个月的后续语言，引人注目的跟踪和fMRI测试。 语言测试结果将用于确定功能生成的适当平衡 实践与单词形式实践以优化SFA结果。吸引人的结果将用于推断 SFA的积极影响是否可以归因于词汇语义表示的激活， 提高了抑制竞争表征或两者兼而有之的能力。 fMRI结果将用于识别 大脑网络和激活变化与SFA导致的命名能力变化有关。这 研究将在理论上和临床上提供有关失语治疗应如何治疗的信息 交付以及其影响的神经认知机制。